A case of disseminated peritoneal leiomyomatosis developing after laparoscope-assisted myomectomy.
A 36-year-old nulliparous woman developed multiple extra-uterine fibroids in the pelvic cavity years after laparoscopic myomectomy. Molecular genetic analysis by methylation-specific polymerase chain reaction (MSPCR) of the human X-linked androgen receptor gene and loss of heterozygosity (LOH) analysis at 5 microsatellite loci was performed on the tumors. All tumors showed an identical non-random X-chromosome inactivation pattern by MSPCR and an identical pattern of LOH was found in all the tumors by LOH analysis. This demonstrated that 3 fibroids resected 2 years later and 14 fibroids resected 6 years later were all metastatic tumors originating from the uterine leiomyoma found during the initial surgery, suggesting that morcellation before removal of the leiomyoma nodule during laparoscopic myomectomy may have been associated with the pathogenesis of this case.
Miyake
Takahito
T
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Enomoto
Takayuki
T
Ueda
Yutaka
Y
Ikuma
Kenichiro
K
Morii
Eiichi
E
Matsuzaki
Shinya
S
Murata
Yuji
Y
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D018231:Leiomyomatosis / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D019656:Loss of Heterozygosity; D018895:Microsatellite Repeats; D010534:Peritoneal Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000175:diagnosis; D011944:Receptors, Androgen / Q000235:genetics; D018570:Risk Assessment; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D049951:X Chromosome Inactivation
D011944:Receptors, Androgen